scholarly journals Primary Hyperparathyroidism with a Low-Normal, Atypical Serum Parathyroid Hormone as Shown by Discordant Immunoassay Curves

2006 ◽  
Vol 91 (10) ◽  
pp. 3826-3829 ◽  
Author(s):  
Fred W. Lafferty ◽  
Clive R. Hamlin ◽  
Kristin R. Corrado ◽  
Andrew Arnold ◽  
Jerry M. Shuck
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Serum Parathyroid Hormone

Systems-Level Opportunities in the Management of Primary Hyperparathyroidism: An Informatics-Based Assessment

2021 ◽  
Author(s):  
Nardeen B Dawood ◽  
Chi-Hong Tseng ◽  
Dalena T Nguyen ◽  
Kimberly L Yan ◽  
Masha J Livhits ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Health System ◽  
Retrospective Cohort ◽  
Surgical Intervention ◽  
Mineral Density ◽  
Serum Parathyroid Hormone ◽  
Academic Health ◽  
Care Gaps

Abstract Context Primary hyperparathyroidism (PHPT), a leading cause of hypercalcemia and secondary osteoporosis, is underdiagnosed. Objective To establish a foundation for an electronic medical record-based intervention that would prompt serum parathyroid hormone (PTH) assessment in patients with persistent hypercalcemia and identify care gaps in their management. Design Retrospective cohort study. Setting Tertiary academic health system. Patients Outpatients with persistent hypercalcemia, who were then categorized as having classic or normohormonal PHPT. Main Outcome Measures The frequencies of serum parathyroid hormone (PTH) measurement in patients with persistent hypercalcemia, and their subsequent workup with bone mineral density (BMD) assessment, and ultimately, medical therapy or parathyroidectomy. Results Among 3151 patients with persistent hypercalcemia, 1526 (48%) had PTH measured, from whom 1377 (90%) were confirmed to have classic (49%) or normohormonal (41%) primary hyperparathyroidism (PHPT). PTH was measured in 65% of hypercalcemic patients with osteopenia or osteoporosis (p<0.001). Upon median two year follow-up, bone density was assessed in 275 (20%) patients with either variant of PHPT (p=0.003). Of women ≥ 50 years of age with classic PHPT, 95 (19%) underwent BMD assessment. Of patients with classic or normohormonal PHPT, 919 patients (67%) met consensus criteria for surgical intervention, though only 143 (15%) underwent parathyroidectomy. Conclusions Within a large academic health system, over half of patients with confirmed hypercalcemia were not assessed for PHPT, including many patients with preexisting bone disease. Care gaps in BMD assessment and medical or surgical therapy represent opportunities to avoid skeletal and other complications of PHPT.

scholarly journals Relationship between serum parathyroid hormone, serum calcium and arterial blood pressure in patients with primary hyperparathyroidism: results of a multivariate analysis

2002 ◽  
pp. 643-647 ◽  
Author(s):  
F Lumachi ◽  
M Ermani ◽  
G Luisetto ◽  
A Nardi ◽  
SM Basso ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Multivariate Analysis ◽  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Arterial Blood Pressure ◽  
Serum Calcium ◽  
Biochemical Parameters ◽  
Serum Parathyroid Hormone ◽  
Arterial Blood ◽  
Serum Pth

OBJECTIVE: To evaluate the possible relationship between serum calcium, serum parathyroid hormone (PTH) levels and arterial blood pressure (BP) in patients with primary hyperparathyroidism (HPT). DESIGN: A retrospective population-based study. METHODS: Charts of 194 patients with proven primary HPT were reviewed, and the main clinical and biochemical parameters were recorded. There were 48 men (24.7%) and 146 women (75.3%), with a median age of 59 years (range 23-82 years). Patients who used antihypertensive drugs or hormone replacement therapy had been previously excluded. All patients underwent successful parathyroidectomy, and were cured of their disease. RESULTS: There were no differences (P=NS) between men and women in systolic (143.3+/-19.1 vs 145.4+/-17.1 mmHg) and diastolic (87.1+/-12.3 vs 88.4+/-9.9 mmHg) BP, and in the main biochemical parameters. A significant (P<0.01) correlation was found between (i) serum calcium and serum PTH levels (r=0.39, F=88.36), (ii) age and BP, both systolic (r=0.61, F=118.16) and diastolic (r=0.48, F=64.5), and (iii) body mass index (BMI) and BP (r=0.45 and 0.36 respectively). There was no significant association of serum calcium levels with systolic (r=0.0974, t=1.3422, P=0.18) or diastolic (r=0.1117, t=1.5409, P=0.12) BP, and of serum PTH levels with systolic (r=-0.0349, t=-0.4783, P=0.63) or diastolic (r=-0.0793, t=-1.0913, P=0.28) BP. Multivariate analysis confirmed that none of the independent biochemical parameters significantly correlated with BP, both systolic and diastolic. CONCLUSIONS: In patients with primary HPT there is no relationship between PTH, calcium and BP. Thus, in hyperparathyroid patients, BP should be considered as an independent variable, mainly related to age and BMI.

Mood and Anxiety Disorders

2016 ◽  
pp. 701-706
Author(s):  
Brian A. Palmer
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Anxiety Disorders ◽  
Related Protein ◽  
Serum Parathyroid Hormone ◽  
Academic Interest ◽  
Mood And Anxiety Disorders ◽  
Common Causes ◽  
Routine Basis

The most common causes of hypercalcemia are malignancies and primary hyperparathyroidism. Patients with primary hyperparathyroidism have increased serum parathyroid hormone (PTH) values, but PTH is usually suppressed in cancer-associated hypercalcemia. Cancer-related hypercalcemia is often mediated by a PTH-related protein (PTHrP), which is secreted by the tumor and can be measured with current assays. In general, however, measuring PTHrP levels is of academic interest only and should not be done on a routine basis.

Parathyroid Hormone Assay in Primary Hyperparathyroidism: Experiences with a Radioimmunoassay Based on Commercially Available Reagents

1974 ◽  
Vol 20 (3) ◽  
pp. 369-375 ◽  
Author(s):  
M Kleerekoper ◽  
J P Ingham ◽  
S W McCarthy ◽  
S Posen
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Human Serum ◽  
Serum Calcium ◽  
Parathyroid Tissue ◽  
Normal Range ◽  
Serum Parathyroid Hormone ◽  
Skeletal Changes ◽  
Parathyroid Hormone Assay ◽  
Positive Correlations

Abstract A radioimmunoassay is described for parathyroid hormone in human serum, in which commercially available reagents are used almost exclusively. This assay can be done by any laboratory with experience in radloimmunoassay. Thirty-two of thirty-three patients with surgically proven primary hyperparathyroidism had detectable concentrations of parathyroid hormone in their serum, and concentrations of the hormone exceeded the normal range in 24 of them. Significant positive correlations were found between pre-operative serum calcium, pre-operative serum parathyroid hormone, and the weight of parathyroid tissue removed at operation. These three parameters were also significantly correlated with severity of the skeletal changes as assessed by semiquantitative histological methods.

PARATHYROID HORMONE SECRETION IN DISORDERS OF CALCIUM METABOLISM STUDIED BY MEANS OF EDTA

1974 ◽  
Vol 75 (2) ◽  
pp. 286-296 ◽  
Author(s):  
J. H. Lockefeer ◽  
W. H. L. Hackeng ◽  
J. C. Birkenhäger
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Calcium Metabolism ◽  
Hormone Secretion ◽  
Parathyroid Tissue ◽  
Small Mass ◽  
Idiopathic Hypercalciuria ◽  
List Type ◽  
Immunoreactive Parathyroid Hormone ◽  
Pth Level

ABSTRACT In 22 of 28 cases of primary hyperparathyroidism (PHP) the rise in the serum immunoreactive parathyroid hormone (IRPTH or PTH) level observed in response to lowering of the serum calcium by EDTA, exceeded that obtained in 8 control subjects. In 5 of these 22 patients who were studied again after parathyroidectomy the supranormal response was abolished. Fifteen of these 22 hyper-responsive PHP patients had basal IRPTH levels not exceeding the highest level in the controls and that of other groups of patients investigated (idiopathic hypercalciuria, non-parathyroid hypercalcaemia, operated PHP). Fourteen of the 22 hyper-reactive patients with PHP did not show hypocalcaemia during the infusion of EDTA. The extent of the release of PTH elicited by EDTA in cases of PHP does not as yet allow a prediction of the amount of pathological parathyroid tissue present, although all the PHP patients showing a normal release of PTH had a relatively small mass of parathyroid tissue (up to about 1 g) subsequently removed. In 9 cases of nephrolithiasis (8 of whom had idiopathic hypercalciuria) and in 7 cases of non-parathyroid hypercalcaemia, a normal PTH release was found.

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